Kornimate/medical-research-clean huggingface dataset:
maintenance therapy for small-cell lung cancer

Conditions: Progression Free Survival

Summary: this study involves patients treated with cisplatin and etoposide (induction therapy), followed by treatment with a drug called s1 (maintenance therapy). the main purpose of this study is to determine if this type of treatment will delay the growth of the tumor and if so, for how long. the primary endpoint is progression free survival and second endpoints are toxicities, overall survival.

small cell lung cancer (sclc) accounts for about 20% of lung cancer, has a high degree of malignancy, short doubling time, early and widespread metastasis, is sensitive to chemotherapy and radiotherapy, and has a high initial response rate, but is prone to secondary drug resistance and relapse. the treatment is mainly based on systemic chemotherapy, and if maintenance therapy with s1 after standard ep regimen induction therapy could prolong progression free survival.

Eligibility criteria:
inclusion criteria: * 1. histopathologically confirmed patients with extensive small cell lung cancer; 2. karnofsky performance status ≥60; 3. at least one lesion that can measured by ct; 4. expected to survive for at least 3 months; 5. peripheral blood and liver and kidney function within the following allowable range (tested within 7 days before treatment); 6. white blood cell (wbc) ≥3.0×109/l or neutrophils (anc) ≥1.5×109/l; hemoglobin (hgb) ≥80 g/l；platelet (plt) ≥100×109/l; 7. liver transaminases（ast/alt）\<3.0 times the normal range limit; total bilirubin（tbil）\<1.5 times the normal range limit; creatinine（creat）\<1.5 times the normal range limit; 8. patients of childbearing age (including female and male patients' partner) must take effective contraception methods; signed informed consent 9. must be able to swallow tablets exclusion criteria: * 1. limited stage disease 2. metastastic meningitis, spinal compression, tumor to main vesicular less than 5mm 3. other pathological types of tumor except for small cell lung cancer; 4. patients with a history of severe allergies or allergies; 5. pregnancy or breastfeeding women; 6. patients who have previously participated in other clinical trials and have not yet terminated the trial; 7. patients who have acute infection that difficult to control; 8. subjects with difficulties in swallowing or known drug malabsorption.
etiological classification-guided individual intervention in primary hypertension

Conditions: Hypertension

Summary: eligible participants will first undergo a 1-week home blood pressure diary and 24-hour ambulatory blood pressure assessment. after a confirmed diagnosis of hypertension, etiological subtyping will be performed. based on the blood pressure evaluation results and etiological classification, the most appropriate antihypertensive medication will be selected. simultaneously, a personalized lifestyle prescription will be provided according to the patient's individual circumstances. following medication initiation, participants will continue to monitor their blood pressure through home diaries. monthly evaluations will be conducted, and if blood pressure fails to reach the target value, medication adjustments will be made based on the blood pressure diary until target levels are achieved. this regimen will be maintained long-term.


Eligibility criteria:
inclusion criteria: * age 18-65 years. * diagnosed primary hypertension (systolic blood pressure ≥140 mmhg or diastolic blood pressure ≥90 mmhg). * signed informed consent. exclusion criteria: * secondary hypertension or arrhythmias affecting blood pressure accuracy (e.g., atrial fibrillation). * comorbidities such as diabetes, chronic kidney disease (egfr \< 30 ml/min/1.73m²), coronary artery disease, heart failure, or serious valvular heart disease. * history of stroke or myocardial infarction. * pregnancy, breastfeeding, or planning to become pregnant. * life expectancy \< 1 year. * participation in another clinical trial.

Keywords: etiological classification digital intervention
home study: a combination support package to increase uptake of prep and hiv/sti testing

Conditions: HIV Prevention; Sexually Transmitted Diseases; Pre-Exposure Prophylaxis

Summary: home hiv self-testing has been fda approved and allows users to read their own hiv test results at home, while home sexually transmitted infection (sti) test self-collection allows men to use a swab at home and mail it in for testing. the purpose of this study is to learn how men who have sex with men (msm) use these new testing options, a set of online support tools, and the option to test with someone to support them (a testing "buddy"). we will also evaluate whether the online tools help these men to connect with hiv prevention services such as pre-exposure prophylaxis (prep) if they test hiv negative, and to hiv care services if they test hiv positive.

participants will be randomized 2:1 after enrollment to the intervention and control condition. data obtained from this study will be used to inform the further tailoring and distribution of an intervention for young black and latino msm to increase utilization of home hiv self-testing and linkage to hiv treatment and pre-exposure prophylaxis (prep).

Eligibility criteria:
inclusion criteria: * self-identify as black or latino. * report anal sex with at least one male sex partner in the prior 12 months. * hiv negative by self-report. * currently own a cell phone. * willing and able to provide written informed consent. exclusion criteria: * inadequate contact information for follow-up. * in a mutually monogamous sexual relationship for the past 12 months. * currently taking prep. * does not have reliable access to the internet. * does not live, work, or play in the san francisco bay area. * planning to move out of the bay area during the 9 month study period. * previously participated in the home pilot study. * any medical, psychiatric, or social condition, or occupational, or other responsibility that, in the judgment of the investigator, would make participation in the study unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving the study objectives.

Keywords: prep hiv prevention risk reduction sti prevention home hiv testing hiv testing sti testing
a prospective, open-label, multi-center pilot study to evaluate the safety, feasibility and usability of the ida

Conditions: Chronic Kidney Disease Stage V

Summary: this is a multi-center, open label, cross-over clinical study. a total of 15 subjects will be enrolled to use the ida for every peritoneal dialysis exchange for 14 days. to participate in the study, the subjects must have current ckd5 and have been treated with pd for at least 3 months. the subjects will undergo a single peritoneal dialysis exchange procedure at the pd clinic, under supervision of the medical staff and instructed about its operation. further exchanges will be performed by the subjects themselves at home. the study includes three periods: first period (observational): 14-day observational period. eligible subjects who sign informed consent will continue with their regular capd treatment while performing measurement and recording of dialysate in/out time. second period (interventional): 14-day interventional period, where subjects will perform dialysis exchanges using the ida according to the below visit schedule. third period (follow up): 14-day follow up period, during which the study staff will call the subject once weekly to inquire about device-related saes and any changes to concomitant medications.


Eligibility criteria:
inclusion criteria: * male and female subjects with ckd stage 5 under peritoneal dialysis * age ≥18 years * mental ability to understand the study procedures and provide informed consent * at least 3 months on peritoneal dialysis prior to enrollment * at least 3 daily exchanges * stable pd prescription for the last 2 months * subject who is self-treated exclusion criteria: * need of cycler (apd) * known mechanical problem during the last month (i.e. drainage or fill problems) * pregnant or breastfeeding women, and women with childbearing potential who is unwilling or unable to use an acceptable method of contraception to avoid pregnancy throughout the entire clinical trial period. * subjects who are unwilling or unable to comply with study procedures * known peritonitis or other catheter related infection during the last 3 months prior to enrollment * known congestive heart failure stage iii-iv * any history of kidney malignancy * any planned hospitalization for elective procedure(s)throughout the duration of participation in the study * non-elective hospitalization in the last 3 months prior to enrollment * any other medical or mental condition, that at the investigator's discretion may prevent the subject from participating in the study * participation in any other clinical study within 4 weeks prior to enrollment
the duration of antibiotic therapy for early (date) ventilator associated pneumonia (vap): 4 vs. 7 days

Conditions: Ventilator Associated Pneumonia

Summary: the purpose of this study is to see if the amount of antibiotics given for ventilator-associated pneumonia (vap) can be decreased in order to reduce the risk of adverse effects associated with antibiotics, while at the same time ensuring the participant's safety.


Eligibility criteria:
inclusion criteria: 1. surgical patient 2. early vap, defined as vap occurring within 2 - 7 days of intubation (via endotracheal or tracheostomy tube) (9). vap will be defined according to local institutional protocol. 3. hospital length of stay (los) \< 10 days at the time of vap diagnosis. 4. patients are willing to provide informed consent or their legally authorized representative (lar) is willing to provide informed consent on their behalf when the patient is unable (i.e., cognitively impaired from sedation on a ventilator) exclusion criteria: 1. age \< 18 years 2. prior episode of vap for the index admission 3. vap caused by any of the following pathogens: * methicillin-resistant staphylococcus aureus (mrsa) * vancomycin-intermediate staphylococcus aureus (visa) * pseudomonas aeruginosa * vancomycin-resistant enterococcus (vre) * acinetobacter baumanii * stenotrophomonas maltophilia * carbapenem-resistant enterobacteriaceae (cre) * extended-spectrum beta lactamase-producing gram-negative bacilli 4. causative pathogen not sensitive to choice of initial empiric antibiotic 5. antibiotic therapy for \> 5 of the last 10 days preceding vap diagnosis 6. septic shock, defined as evidence of tissue hypoperfusion after adequate volume expansion, due to infection, and requiring \> 1 vasopressor (17) 7. current or recent (within 30 days) use of immunosuppressive medications 8. los \> 72 hours at a transferring facility 9. pregnancy or lactation 10. legal arrest or incarceration 11. moribund state in which death is imminent 12. ecmo (extracorporeal membrane oxygenation) 13. extubation prior to randomization
effect of silymarin against methotrexate-induced liver injury in rheumatic diseases

Conditions: Rheumatoid Arthritis; Psoriatic Arthritis; Psoriasis

Summary: to study the effect of silymarin against methotrexate-induced liver injury in rheumatic diseases including rheumatoid arthritis, psoriatric arthritis and psoriasis

- methotrexate was indeed a common and effective treatment for rheumatoid arthritis, psoriatic arthritis and psoriasis. methotrexate-related hepatotoxicity are common occur 1:1,100 persons. liver abnormalities varies from asymptomatic liver enzyme elevation to fatal hepatic necrosis and liver fibrosis. methotrexate was discontinued owing to liver dysfunction in 7.4%

Eligibility criteria:
inclusion criteria: * aged \> 20 years * diagnosis at least one of the following 1. rheumatoid arthritis according to american college of rheumatology/ the european alliance of associations for rheumatology 2010(acr/eular2010) with at least one joint swelling or tenderness or 2. psoriatric arthritis according to caspar classification criteria with at least one joint swelling or tenderness, or at least one site dactylitis or enthesitis or psoriasis by dermatologist with active skin lesion 3. no previous treatment with methotrexate or treatment with methotrexate within 30 day before randomization 4. no previous treatment with other conventional synthetic dmards other than methotrexate such as sulfasalazine, hydroxycholoquine, leflunomide 5. no previous treatment with biologic dmards such as anti-tnf 6. can follow the treatment protocal exclusion criteria: * pregnancy or planning for pregnancy * breastfeeding women * ongoing treatment with active malignancy * gfr \< 30 ml/min/1.73m2 * previous documented of hiv infection * chronic alcohol drinking ≥ 3 times/wk or drug abuse within 6 months prior to randomization * positive of hbsag, anti hcv * previous documented of preexisting liver disease such as alcoholic liver disease, liver cirrhosis, autoimmune hepatitis * ast or alt \> uln ( 0-50 u/l ) * wbc \< 3,000/ul or platelet \< 100,000 /ul, anc \< 1,500/ul * ild diagnosed by rheumatologist and pulmonologist from chest x ray and hrct * history documented silymarin hypersensitivity or severe adverse effects diagnosed by physician or pharmacist from pmk hospital or from history drug allergy or symptoms such as rash, chest tightness, dyspnea, diarrhea and hypotension * cannot follow up on treatment protocal

Keywords: rheumatoid arthritis psoriatric arthritis psoriasis methotrexate silymarin
primary tumour response to induction chemotherapy in synchronously metastasized colorectal cancer

Conditions: Gastrointestinal Neoplasm

Summary: we performed a retrospective data analysis of patients with synchronously metastasized colorectal cancer, comparing the histological response on the primary tumour to chemotherapy combined with either vascular endothelial growth factor (vegf) or epidermal growth factor receptor (egfr) inhibition.

we performed a retrospective analysis regarding the response of the primary tumour and the liver metastases of patients with colorectal carcinoma to an induction chemotherapy with antibody therapy, either with a vegf antibody, or with an egfr antibody. we investigated 100 patients with synchronous metastatic colorectal carcinoma, who underwent hepatic resection in clinic landstraße or clinic favoriten between 2014 and 2021. we investigated the tumour response of the primary tumour, using rödel score, which is a tumour regression score. we also investigated the tumour response of the liver metastases using rubbia brandt tumour regression score. the pathological response was assessed postoperatively in the surgical specimen. in order to ensure a uniform assessment, the pathologists in our hpb center assessed the histological specimens from both treatment locations prior to this analyses. the tumour response of the liver metastases was assessed twice: by radiological tumour assessment via computer tomography (ct) of the abdomen or magnetic resonance imaging (mri) of the liver with recist criteria. postoperative complications less than 90 days after liver resection were assessed and described according to the classification system by dindo et al. day of tumour recurrence and/or death was assessed. we also investigated the difference of recurrence free survival (rfs) and overall surcical (os) between the patients, who received egfr and the patients, who received vegf antibody treatment.

Eligibility criteria:
inclusion criteria: * older than 18 years * synchronously hepatic metastasized patients with colorectal carcinoma * indication of surgical treatment exclusion criteria: * younger than 18 years * metachronously metastasized patients

Keywords: colorectal cancer synchronous liver metastases targeted therapy tumour regression grading
assessment of pocd after steep trendelenburg position and co2 pneumoperitoneum with cerebral oxygen

Conditions: Postoperative Cognitive Dysfunction

Summary: postoperative cognitive decline (pocd) is a common and impactful outcome of surgical procedures in older adults. the pathophysiology and causative mechanisms for pocd are poorly understood. the robot-assisted radical cystectomy (rarc) is increasingly utilized. in patients undergoing rarc, although prolonged trendelenburg position and pneumoperitoneum can increase the cerebral blood flow, the excessive cerebral perfusion can lead to encephalemia, which reduce the oxygen uptake of brain tissue and cause insufficient oxygenation of brain tissue at the cellular level. pocd may take place due to cerebral hemodynamic changes. the goal of the current study is to investigate the combined effect of this position and co2 pneumoperitoneum on pocd during rarc with the monitor of cerebral oxygen.

postoperative cognitive decline (pocd) is a short-term decline in cognitive function (especially in memory and executive functions) that may last from a few days to a few weeks after surgery. it is a common and impactful outcome of surgical procedures in older adults. the pathophysiology and causative mechanisms for pocd are poorly understood. it is supposed to be associated with numerous factors such as ages, trauma, inflammation, surgical stress, position, fluid, mbp, artificial pneumoperitoneum , pco2, fio2. the robot-assisted radical cystectomy (rarc) is increasingly utilized. in patients undergoing rarc, although prolonged trendelenburg position and pneumoperitoneum can increase the cerebral blood flow, there were studies showed that the excessive cerebral perfusion can lead to encephalemia, which reduce the oxygen uptake of brain tissue and cause insufficient oxygenation of brain tissue at the cellular level. pocd may take place due to cerebral hemodynamic changes. contemporary, intraoperative fluid restriction, a relatively long time of operation and surgical stress may also contribute to pocd. the goal of the current study is to investigate the combined effect of this position and co2 pneumoperitoneum on pocd during rarc with the monitor of cerebral oxygen.

Eligibility criteria:
inclusion criteria: * above age of 55 * will undergo the robot-assisted radical cystectomy * informed consent, volunteered to participate in this experiment, asa i - iii exclusion criteria: * audio and visual impairment, illiteracy * existing severe central nervous system disease * patients with central nervous system disease or surgery , resulted in severe sequelae * alcohol dependence * take psychotropic medications * preoperative mmse score was less than 24

Keywords: pocd rarc trendelenburg position
progressive muscle relaxation vs muscle energy technique on nonspecific neck pain in prolonged computer users.

Conditions: Neck Pain; Chronic Neck Pain

Summary: the objective of this randomized controlled trial is to assess the potential effectiveness of progressive muscle relaxation technique (pmrt) vs muscle energy technique (met) as an intervention for releasing trigger points in scm and upper trapezius in prolonged computer users. the study will be conducted in a workplace setting, where desk-type computer users are expected to regularly engage in their professional activities for ≥ 6 hours throughout the day, intermittently. this study will be conducted at the outpatient physiotherapy department of sindh institute of physical medicine and rehabilitation, karachi among 60 patients with nonspecific chronic neck pain on the basis of non-probability purposive sample technique. after taking informed consent, all participants will be randomly allocated into two groups through a investigator (blinded) the same investigator will be screening the individuals, doing baseline assessment, and post treatment assessment while another investigator will be providing intervention. group 1 will receive progressive muscle relaxation technique while group 2 will receive muscle energy technique on sternocleidomastoid and upper trapezius bilaterally. patients will also be blinded. a total of 12 sessions will be provided. outcomes will be assessed at baseline and post treatment after 2 weeks intervention.


Eligibility criteria:
inclusion criteria: * persons using computer more than 6 hours throughout the day, intermittently both genders. * age between 20-45. * hypertonicity of trapezius muscle and scm muscle. specifically, those workers have neck pain and stiffness (including trouble tilting or turning head). patients who reported small tightening and spasm at the posterior aspect of their neck are included, also associated with more diffuse neck pain patterns that included the following: headache, (upper back, neck and shoulder pain) numbness/ tingling in the hand/arm. * pain intensity of 2 on the nrs and presence of at least one latent trigger point in a taut band in the neck region. exclusion criteria: * recent trauma to the cervical region * exclusion criteria based on with any serious pathology such as specific neck pain due to disc prolapsed, tumor of cervical spine, whiplash injury, cervical fractures, cervicogenic headache, and any neurological signs consistent with nerve root compression

Keywords: chronic pain computer user muscle relaxation progressive muscle relaxation, neck pain chronic neck pain sternocleidomastoid muscle trapezius neck pain musculoskeletal
genetics of symptomatology and treatment response in psychotic major depression

Conditions: Psychotic Disorders; Depressive Disorder; Depressive Disorder, Major

Summary: we hope to learn more about the biology of psychiatric illness with the hope of improving the diagnosis and treatment of such psychiatric conditions as major depression.

from the blood sample you donate, the researchers will obtain dna. this dna will be used to search for dna markers related to the underlying biology of psychiatric illness and how this might explain the symptoms of these disorders. research using dna is an important way to try to understand human disease and/or the role genes play in disease. in effect, part of your blood sample will be used to attempt to understand how genetic factors contribute to the symptoms of such psychiatric conditions as major depression.

Eligibility criteria:
inclusion criteria: 1. you are currently experiencing symptoms that are consistent with an episode of major depression without symptoms of psychosis (such as hallucinations, delusions or disorder of thought process), or 2. you are currently experiencing symptoms that are consistent with an episode of major depression with symptoms of psychosis (such as hallucinations, delusions or disorder of thought process), or 3. you have been diagnosed with either schizophrenia or schizoaffective disorder, or 4. you are a volunteer without a history of psychiatric illness (a healthy control subject).
the delayed intervention and surveillance for small renal masses (dissrm) registry

Conditions: Kidney Neoplasm

Summary: retrospective studies indicate that active surveillance for clinically localized, small renal masses (ct1a, \<=4cm) is safe. it is our hypothesis that active surveillance is safe and efficacious when compared prospectively to patients undergoing immediate intervention for their small renal mass.

all patients are offered active surveillance or immediate intervention, as applicable, prior to being offered consent for the dissrm registry. all patients are enrolled and followed prospectively. surveillance patients are followed per protocol with serial imaging, blood work and quality of life questionnaires. intervention patients are followed at the discretion of the attending surgeon with serial qol appointments/questionnaires.

Eligibility criteria:
inclusion criteria: * must have a solid, enhancing renal mass ≤4cm at its greatest dimension found on incidental scanning in the last 6 months. * age ≥ 18 and able to read, understand and sign informed consent. * must be willing to adhere to the treatment algorithm and time constraints therein. exclusion criteria: * cannot have suspicion of metastases to the kidney if any other malignancy diagnosed within two years of study entry.

Keywords: small renal mass active surveillance